THE SIGNIFICANCE OF THE PSYCHOSOCIAL WORK Publication...آ  2016-05-25آ  the significance of the psychosocial

Embed Size (px)

Text of THE SIGNIFICANCE OF THE PSYCHOSOCIAL WORK Publication...آ  2016-05-25آ  the significance of the...

  • THE SIGNIFICANCE OF THE PSYCHOSOCIAL WORK

    ENVIRONMENT FOR CARE WORKERS`PERCEIVED HEALTH,

    PRESENTEEISM, RATIONING OF CARE, AND JOB

    SATISFACTION: A SUB-STUDY OF THE SWISS NURSING HOME

    HUMAN RESOURCES PROJECT (SHURP)

    INAUGURALDISSERTATION

    zur

    Erlangung der Würde eines Dr. sc. med.

    vorgelegt der

    Medizinischen Fakultät der Universität Basel

    von

    Suzanne R. Dhaini aus Libanon / Kanada

    Basel, 2016

    Original document stored on the publication server of the University of Basel edoc.unibas.ch

    This work is licensed under a Creative Commons Attribution-NonCommercial NoDerivatives

    4.0 International License

  • 2

    Genehmigt von der Medizinischen Fakultät

    auf Antrag von:

    Fakultätsverantwortliche Prof. Dr. S. De Geest

    Dissertationsleitung PD Dr. R. Schwendimann

    Co-Referat Prof. Dr. M. Simon

    Externes Referat Prof. Dr. R. Kunz

    Externes Referat Prof. Dr. A. Matthews

    Basel, den 14. März, 2016

    Dekan Prof. Dr. med. T. Gasser

  • 3

    LIST OF ABBREVIATIONS

    ADL Activities of Daily Living

    BBF Blood and Body Fluid

    BERNCA-NH Basel Extent of Rationing of Nursing Care - Nursing Home Version

    β Beta Coefficient

    CNA Certified Nursing Assistant

    COBB Fragebogen zur Erfassung von affektiven, kalkulatorischem und

    normativem, Commitment`gegenüber der Organisation, dem Beruf/der

    Tätigkeit und der Beschäftigungsform CI Confidence Interval

    DRG Diagnostic Related Group

    EU-OSHA European Agency for Safety and Health at Work

    GEE Generalized estimation equations

    HPSI health Professions Stress Inventory

    I-CVI Item Content Validity Index

    IOM Institute of Medicine

    LPN Licensed Practical Nurse

    MBI Maslach Burnout Inventory

    NA Nurse Aide

    OR Odds Ratio

    OSHA Occupational Safety and Health Administration

    PES-NWI Practice Environment Scale-Nursing Work Index

    RN Registered Nurse

    SAQ Safety Attitude Questionnaire

    S-CVI Scale Content Validity Index

    SHURP Swiss Nursing Home Human Resources Project

    WHO World Health Organization

  • 4

    TABLE OF CONTENTS

    ACKNOWLEDGEMENTS 7

    PREFACE 9

    SUMMARY 10 REFERENCES 14

    CHAPTER 1 INTRODUCTION 16 1.1 WORK RELATED HEALTH AMONG CARE WORKERS: THE MAGNITUDE OF THE PROBLEM 18 1.2 PRESENTEEISM: AN EMERGING PROBLEM 20 1.3 DETERMINANTS OF WORK-RELATED HEALTH AND PRESENTEEISM 21 1.4 EFFECT OF HEALTH AND PRESENTEEISM ON RATIONING OF CARE 24 1.5 THE EFFECT OF WORK ENVIRONMENT AND HEALTH ON JOB SATISFACTION 24 1.6 THE WHO MODEL FOR HEALTHY WORKPLACE 25 1.7 IDENTIFIED RESEARCH GAPS AND DISSERTATION RATIONALES 27 1.8 STUDY AIMS 29 1.9 REFERENCES 30

    CHAPTER 2 CARE WORKERS HEALTH IN SWISS NURSING HOMES AND ITS ASSOCIATION WITH PSYCHOSOCIAL WORK ENVIRONMENT 38 2.1 ABSTRACT 39 2.2 INTRODUCTION 40 2.3 CONCEPTUAL FRAMEWORK 41 2.4 METHODS 43 2.5 RESULTS 47 2.6 DISCUSSION 57 2.7 STRENGTHS AND LIMITATIONS 59 2.7 CONCLUSIONS 59 2.8 FUNDING/ POTENTIAL COMPETING INTERESTS 60 2.9 ACKNOWLEDGEMENTS 60 2.10 REFERENCES 61

  • 5

    CHAPTER 3 ABSENTEEISM AND PRESENTEEISM AMONG CARE WORKERS IN SWISS NURSING HOMES & THEIR ASSOCIATION WITH PSYCHOSOCIAL WORK ENVIRONMENT: A MULTISITE CROSS-SECTIONAL STUDY 65 3.1 ABSTRACT 66 3.2 INTRODUCTION 67 3.3 THEORETICAL BACKGROUND 68 3.4 METHODS 71 3.5. RESULTS 76 3.6 DISCUSSION 83 3.7 STRENGTHS AND LIMITATIONS 84 3.8 CONCLUSION 85 3.9 FUND/CONFLICT OF INTEREST 85 3.10 ACKNOWLEDGEMENTS 85 3.11 REFERENCES 86

    CHAPTER 4 CARE WORKERS` HEALTH, PRESENTEEISM, AND IMPLICIT RATIONING OF CARE IN NURSING HOMES: A MULTISITE CROSS- SECTIONAL STUDY 89 4.1 ABSTRACT 90 4.2 BACKGROUND 91 4.3 METHODS 94 4.4 ETHICAL APPROVAL 97 4.5 RESULTS 97 4.6 DISCUSSION 105 4.7 STRENGTHS AND LIMITATIONS 106 4.8 CONCLUSION AND IMPLICATION FOR NURSING MANAGEMENT 106 4.9 REFERENCES 107

  • 6

    CHAPTER 5 FACTORS ASSOCIATED WITH JOB SATISFACTION AMONG CARE WORKERS IN SWISS NURSING HOMES ---A CROSS SECTIONAL STUDY 110 5.1 ABSTRACT 111 5.2 BACKGROUND 112 5.3 METHODS 114 5.4 RESULTS 120 5.5 DISCUSSION 125 5.6 STRENGTHS AND LIMITATIONS 127 5.7 CONCLUSIONS 127 5.8 ETHICS APPROVAL 128 5.9 COMPETING INTERESTS 128 5.10 FUNDING 128 5.11 AUTHORS’ CONTRIBUTIONS 128 5.12 ACKNOWLEDGEMENTS 128 5.13 REFERENCES 129

    CHAPTER 6 SYNTHSIS AND DISCUSSION 133 6.1 SYNTHESIS OF KEY FINDINGS 134 6.2 DISCUSSION OF KEY FINDINGS 135 6.3 THEORETICAL BACKGROUND, CONCEPTUALIZATION AND MEASUREMENTS OF CARE WORKERS`

    HEALTH 139 6.4 STRENGTHS AND LIMITATIONS OF METHODS 141 6.5 IMPLICATIONS FOR PRACTICE 142 6.6 IMPLICATIONS FOR FUTURE RESEARCH 144 6.7 CONCLUSIONS 145 6.8 REFERENCES 147

  • 7

    ACKNOWLEDGEMENTS

    For the last couple of years I have been planning the day I will pen my acknowledgements

    and pour out my soul, but now that the moment has come, I find myself blank.... Though only my

    name appears on the cover of this dissertation, a great many people have contributed to its

    production. It was the end result of a long and tedious process encompassing sedulity,

    disappointments, joy, and a conducive learning environment, full of encounters with real mentors,

    who were the crowning achievers of my success. I owe my gratitude to all those who have made this

    dissertation possible and because of whom my PhD experience has been one that I will cherish

    forever.

    First and foremost, I would like to thank the four members of my PhD Committee. A sincere

    thankfulness goes to my advisor, Dr. René Schwendimann for his wisdom and guidance. I have been

    amazingly fortunate to have an advisor who gave me the freedom to explore on my own and at my

    own pace, and at the same time the guidance to recover when my steps faltered. His patience,

    support, encouragement, and flexibility helped me overcome many crisis situations and finish this

    dissertation. I am also thankful to him for carefully reading and commenting on countless revisions of

    all my manuscripts. He is a real mentor.

    I would like to extend my greatest appreciation to my co-advisor, Prof. Dr. Michael Simon,

    who kept a sense of humor when I had lost mine. With his open door policy, he has been always

    there to listen, to answer my late night emails about perplexing statistical tools and results, and to

    give advice. I am also thankful for enforcing strict validations for each research result, and thus

    teaching me how to do research. I am deeply thankful!

    My motivation to contribute to the research of health of the nursing workforce is derived from

    their dedication and passion for nursing research, where our meetings had always been rich with

    fruitful discussions, reflections, and lots of encouragements. They provided the basis of my

    professional growth.

    I would like to express my heartfelt gratitude to Prof. Dr. Sabina De Geest, who believed in

    me and opened the doors wide for me to come to Basel and to prove to myself, and the rest, that I

    could succeed! Her insightful comments at different stages of my research were thought provoking

    and they helped me focus my ideas. I am grateful to her for holding me to a high research standard.

    Her maddening astuteness and attention to details drove me to finally learn to think broader and

    become the researcher I have become today.

    I also gratefully acknowledge the limitless support of Dr. Regina Kunz for her numerous

    revisions of my manuscripts and valuable comments, which helped me improve my knowledge on

    related topics.

  • 8

    Special thanks go to Prof. Dr. Sandra Engberg, who provided highly appreciated feedback on

    the conceptualization and development of the papers in the early phase of this dissertation.

    I offer my deep appreciation to the SHURP team Dr. Franziska Zuniga and Dr. Dietmar

    Ausserhofer, in addition to Kris Denhaerynck, from whom I benefited tremendously through

    collaboration and discussion of pressing and arising questions.

    I also appreciate the other types of support I have received throughout this process. Fulfilling

    successfully all steps of the dissertation would have been impossible without colleagues who

    acknowledged the challenges of this tiresome process. Hence, i thank all members of the Institute of

    Nursing Science (INS) at the University of Basel, particularly the A-team (Greet Van Malderen,

    Branda Marcus, Klara Remund, Cornelia Kern, and Michael Huber), whose impeccable

    administrative support facilitated my life at the institute in countless ways. I would also like to thank

    all PhD fellow peers, especially Sonja Beckmann who escorted me on the train routinely, back and

    forth to Basel and Zurich, recognizing my daily challenges.

    Further, I dedicate this dissertation to my family, who offered me other types of support. To

    my mom, whose constant and unwavering encouragement and prayers, and her willingness to look

    after my children in the last four years, made this possi